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HomeMy WebLinkAbout206064 ARNOLD BURNS DBA A & B TRUCKING - INSURANCE CERTIFICATE (7)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MM/DD/YYYY) A&BTRU2 07 20 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Truck Insurance Specialists, I HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6075 East 60th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Commerce City CO 80022 Phone: 303-289-4485 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Wilshire Insurance Company 13234 INSURER B: A 6 B Trucking Arnold & Bever1 Yy Burns dba INSURER C: 420 East 57th #55 Loveland CO 80538 INSURER D: INSURER E: 181O 4Z7.tei*. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSR TYPE OFINSURANCE POLICY NUMBER DATEYMWDD/YV POLICY DATE MMDDlYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE n OCCUR MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 17 POLICY F7 PROJECT LOC X AUTOMOBILE LIABILITY ANY AUTO INED (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A ALLLIMIT ALL OWNED AUTOS SCHEDULEDAUTOS BA2480056 07/08/04 07/08/05 X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY T RRY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS The certificate holder is named as Additional Insured with respects to the Auto Liability coverage L,r K I IrwA l t MULUerc CANCELLATION CITYFCl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIC DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Dept P O Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80524 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) © ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 2s onnvnm